Active NPI
Renee Somar Ryan, LICENSED MASSAGE THE
- Massage Therapist
- Winfield, IL
National Provider Identifier
1134828247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227.000464
- Practice address
- 0S 165 Church Street
Winfield, IL 60190-1245 - Phone
- (630) 352-9097
- NPI assigned
- Feb 27, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227.000464 | IL | Primary |
Addresses
Primary practice location
0S 165 Church Street
Winfield, IL 60190-1245
Mailing address
612 Eklund Avenue
Geneva, IL 60134-1334
Phone (830) 352-9097
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227.000464 | IL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677456000000",
"number": "1134828247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 EKLUND AVENUE",
"city": "GENEVA",
"state": "IL",
"postal_code": "601341334",
"telephone_number": "830-352-9097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "0S 165 CHURCH STREET",
"city": "WINFIELD",
"state": "IL",
"postal_code": "601901245",
"telephone_number": "630-352-9097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "RENEE",
"middle_name": "SOMAR",
"name_prefix": "Ms.",
"credential": "LICENSED MASSAGE THE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-27",
"last_updated": "2023-02-27",
"certification_date": "2023-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227.000464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.